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Individual

THOMAS A COFFIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LADC

Contact information

Practice address
302 STEVENS AVE, PORTLAND, ME 04103-2628
(207) 865-0443
Mailing address
PO BOX 164, FREEPORT, ME 04032-0164
(207) 865-0443

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3739
ME
1041C0700X
Clinical Social Worker
Primary
LC10734
ME

Other

Enumeration date
09/11/2007
Last updated
09/11/2007
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